Evidence mapPaperPMID 39551773Full record

Trial reportBMC medicine2024

Effect of combined treatment with transcranial direct current stimulation and repetitive transcranial magnetic stimulation compared to monotherapy for the treatment of chronic insomnia: a randomised, double-blind, parallel-group, controlled trial.

Qi Zhou, Zhiwang Liu, Chang Yu, Qiao Wang, Wenhao Zhuang, Yafang Tang, Tianming Zheng, Haihang Yu, Dongsheng Zhou

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. Review
  9. Review
  10. Review
  11. Article
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Qi Zhou *Department of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Zhiwang Liu *Department of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Chang YuDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Qiao WangDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Wenhao ZhuangDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Yafang TangDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Tianming ZhengDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Haihang YuDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China.
Dongsheng ZhouDepartment of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, 315201, China. wyzhouds@sina.com.

Funding

the Natural Science Foundation of Zhejiang No.LTGD24H090001the Ningbo Clinical Medical Research Centre for Mental Health No.2022L002the Ningbo medical and health brand discipline No.PPXK 2024-07the Ningbo Natural Science Foundation Project No. 2021J275 and No. 2022J269the Ningbo Public Welfare Project No. 2022S022the Ningbo Top Medical and Health Research Program No.2022030410the Traditional Chinese Medicine Science and Technology Plan Project of Zhejiang Province No. 2021ZB266
6 · The paper itself

Abstract

backgroundChronic insomnia increases the risk of various health problems and mental illness. Existing research suggests promise for both transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in treating chronic insomnia individually. However, the combined effects of tDCS and rTMS on this condition remain unclear. This study aimed to verify the efficacy and safety of tDCS combined with rTMS for the treatment of adult patients with chronic insomnia.

methodsThis was a randomised double-blind parallel-group controlled study. Overall, 157 participants with chronic insomnia were randomly assigned to one of three neurotherapy regimens: tDCS + rTMS, sham tDCS + rTMS, or tDCS + sham rTMS. All groups received 20 treatment sessions over 4 consecutive weeks. The primary outcome was the change in patients' sleep as assessed by the Pittsburgh Sleep Quality Index (PSQI) at 2 weeks, 4 weeks, and 3 months of follow-up. The secondary outcome was the assessment of different dimensions of depression and anxiety in patients through the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), as well as the occurrence of adverse events.

resultsThroughout the intervention and after the 3-month follow-up, the tDCS + rTMS group had significantly reduced total PSQI scores compared with the other two groups [tDCS + rTMS, 9.21 vs. sham tDCS + rTMS, 10.03; difference - 1.10; 95% confidence interval (CI), - 1.82 to - 0.38; p = 0.003; tDCS + rTMS, 9.21 vs. tDCS + sham rTMS, 10.76; difference - 2.14; 95% CI, - 2.90 to - 1.38; p < 0.001; sham tDCS + rTMS, 10.03 vs. tDCS + sham rTMS, 10.76; difference - 1.04; 95% CI, - 1.82 to - 0.26; p = 0.010), indicating improved overall sleep quality. Total HAMD and insomnia factor scores were significantly lower in the tDCS + rTMS group than in the other two groups after treatment (p < 0.05). Notably, no adverse events or serious adverse reactions were observed during the study period.

conclusionsCombining tDCS with rTMS effectively relieved insomnia symptoms, achieving a significant therapeutic effect after 2-week of intervention, and demonstrating the persistence of treatment effects in later follow-up, emphasising the advantages of combination therapy in improving treatment stability and long-term benefits, reflecting the rapid and effective augmentation of combination therapy. This combined therapy may serve as a safe and effective treatment for adults with chronic insomnia.

trial registrationThis study was registered as a clinical trial with the China Clinical Trial Registration Center (ChiCTR2100052681).

Indexed as

Sleep Initiation and Maintenance DisordersTranscranial Direct Current StimulationTranscranial Magnetic StimulationAdultAgedCombined Modality TherapyDouble-Blind MethodFemaleHumansMaleMiddle AgedTreatment OutcomeChronic insomniaClinical trialCombined therapyRepetitive transcranial magnetic stimulationTranscranial direct current stimulation

Identifiers

PMID39551773
PMCPMC11571512

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.